Factors related to COVID-19 vaccine effectiveness perception in racially diverse adults in Canada.

While disparities in COVID-19 vaccine confidence, mistrust, hesitancy, and uptake are well documented, the perception of vaccine efficacy remains understudied in Canada. This study investigates racial differences in COVID-19 vaccine efficacy perception and examines associated factors across Arab, Asian, Black, Indigenous, and White populations. A representative sample of 4220 participants (2358 women) aged 16 and older completed measures assessing perception of COVID-19 vaccine efficacy, conspiracy beliefs, health literacy, and racial discrimination in healthcare settings. Data were collected through a randomly selected online panel in October 2023. The overall mean vaccine efficacy perception score was 17.1 (SD = 4.5), with significant variation across racial groups (F(6, 4213) = 8.0, p < .001). Asian participants (M = 18.4; SD = 3.1) reported higher scores compared to Arab (M = 17.0; SD = 4.3), Black (M = 17.2; SD = 4.3), Indigenous (M = 16.4; SD = 5.2), and White (M = 17.1; SD = 4.4) participants. The most important factors associated with vaccine efficacy perception were conspiracy beliefs (β = -0.32, p < .001), health literacy (β = 0.07, p < .001), and the number of vaccine doses in White individuals. Conspiracy beliefs (β = -0.19, p < .001), higher education (β = 0.28, p < .001), health literacy (β = 0.16, p < .001), more vaccine doses (β = 1.61, p < .001), and experiences of racial discrimination in healthcare prior to accounting for conspiracy beliefs (β = -0.10, p < .05) were the most important factors for racialized individuals. This study highlights significant differences in COVID-19 vaccine efficacy perceptions across racial groups. The findings underscore the impact of factors such as conspiracy beliefs, health literacy, education level, age, and racial discrimination in healthcare on vaccine efficacy perceptions. Public health strategies should address misinformation, prioritize health literacy, and promote anti-racist practices in healthcare to improve vaccine confidence and acceptance.